EP0153190B1 - Endoscopic ovum picker instruments - Google Patents
Endoscopic ovum picker instruments Download PDFInfo
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- EP0153190B1 EP0153190B1 EP85301118A EP85301118A EP0153190B1 EP 0153190 B1 EP0153190 B1 EP 0153190B1 EP 85301118 A EP85301118 A EP 85301118A EP 85301118 A EP85301118 A EP 85301118A EP 0153190 B1 EP0153190 B1 EP 0153190B1
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- Prior art keywords
- ovum
- picking
- needle
- tip
- hole
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/303—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the vagina, i.e. vaginoscopes
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
- A61B1/018—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor for receiving instruments
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/42—Gynaecological or obstetrical instruments or methods
- A61B17/425—Gynaecological or obstetrical instruments or methods for reproduction or fertilisation
- A61B17/435—Gynaecological or obstetrical instruments or methods for reproduction or fertilisation for embryo or ova transplantation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3474—Insufflating needles, e.g. Veress needles
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
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- Animal Behavior & Ethology (AREA)
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- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
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- General Health & Medical Sciences (AREA)
- Medical Informatics (AREA)
- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Reproductive Health (AREA)
- Radiology & Medical Imaging (AREA)
- Gynecology & Obstetrics (AREA)
- Physics & Mathematics (AREA)
- Pathology (AREA)
- Optics & Photonics (AREA)
- Biophysics (AREA)
- Transplantation (AREA)
- Pregnancy & Childbirth (AREA)
- Endoscopes (AREA)
Description
- This invention relates to endoscope means as described in the preamble of Claim 1 or
Claim 4, but incorporating a channel intended for an ovum picker that is inserted through said channel for picking up ovum from an ovarian follicle without injuring it, whilst providing for visual observation through said endoscope means to be maintained throughout the operation. - Since the first success in achieving birth of an externally fertilized baby, by Steptoe in the United Kingdom in 1978, interest in external fertilization has been increasing all over the world, including Japan, and the clinical application has been tried in various facilities. There have been reported about 400 cases of birth of externally fertilized babies.
- In order to effect external fertilization, it is necessary to pick up the ovum from the mother. As reported by Mr Suzuki et al of the Medical Department of Tohoku University, in the Journal of the Japanese Sterilization Society, No. 4, Vol. 28, 1983, the ovum has been picked up by sucking it through a suction needle inserted through a hole formed through abdominal skin whilst under observation through an abdominal endoscope inserted through another hole pierced through the abdominal skin.
- Conventional aspirator needles, as employed for picking up an ovum, are formed as a hollow needle for a syringe, with an inner diameter of about 1.0 mm for picking up the ovum, outer diameter of about 2.0 mm and a length of about 200 to 250 mm. It has sharp edge at the top thereof for piercing the ovarian follicle grown at the surface of the ovary so that the precious ovum which had been carefully protected during long menstruation frequently has been injured by the sharp needle edge during the piercing process.
- Moreover, if slight damage caused by the piercing of the needle is not detected, and the fertilization succeeds, a defective human or animal baby will be born. Hence, the utmost care should be exercised in picking up an ovum, the piercing with the needle, external fertilization, implantation and pregnancy.
- For the picking up of ovum, the needle must be pierced through the ovarian follicle. The sharp edge of the aspirator needle tip in said conventional practice should be pierced deeply, after the piercing for aspirating and picking up the ovum, with the result in possible damage to the ovum in the ovarian follicle. Particularly, when such an operation is to be performed on a human being, the picking up of ovum is very dangerous.
- Moreover, when a fine hole or opening is to be provided for aspirating and picking up ovum and the aspirator needle tip is protruded, the ovarian follicle is displaced, making the formation of a suitable fine hole difficult, and piercing may lead to damage of the inner ovum by the sharp edge. However, said conventional aspirator needle has an advantage in that the ovarian follicle is easily displaced to be pierced in a desired site.
- Nevertheless, since said conventional aspirator needle necessitates not only a pierced hole for the abdominal endoscope but also a pierced hole through the abdominal wall for picking up the ovum the needle is not favourable for a patient or an animal. In addition, said conventional aspirator needle has the disadvantage that the aspirator needle for picking up the ovum is independent of the abdominal endoscope and has to be manipulated independently, reducing the workability.
- An ovum picking up tool for the external fertili, zation is claimed in the West German Utility Model No. 76 15 524. An endoscope incorporating a channel is claimed, for example in the US Patent No. 4 252 122 and the West German Utility Model No. G81 04 329.5.
- An arthroscope having the combination of features set out in the preamble of Claim 1 is described in the US Patent Specification No. 4 369 768.
- One object of the present invention is to provide endoscope means wherein the inlet mouth of channel through the endoscope is partitioned into a plurality of compartments so as to permit the insertion of a plurality of tools, such as a tool for picking up ovum and a clamping forceps concurrently through the channel, so that the clamping forceps may clamp the ovarian follicle firmly when said tool for picking up the ovum is pierced through the ovarian follicle to effect the manipulation for picking up the ovum safely and accurately.
- Another object is to provide endoscope means wherein the endoscope means and tool for picking up the ovum can be inserted integrally through the abdominal wall by providing a single piercing hole therethrough, the ovum within the ovarian follicle can be picked up under the visual observation through said endoscope means, thereby mitigating the pain of the patient and improving the operability by surgeons.
- A further object is to provide a tool for picking up the ovum wherein the aspirator needle or capillary tube is designed to be movable through the sheath tube for aspirating and picking up the ovum from the ovarian follicle and to be fixative with the sheath tube by manipulating the needle at the handle end to pick up the ovum safely and efficiently without injuring the ovum, operated by a single operator or a small number of operators.
- In accordance with one aspect of the invention there is provided an endoscope ovum picker instrument incorporating the features set out in the characterising part of Claim 1.
- The invention will now be described with reference to the drawings, in which:-
- Figure 1 shows a plan view of a first exemplary embodiment of an abdominal endoscope or laparascope;
- Figure 2 is an enlarge front view of the abdominal endoscope of Figure 1;
- Figure 3 is enlarged sectional view of the handle of the abdominal endoscope of Figure 1;
- Figure 4 shows pressure welded member forming a clamping and fixing means for use with the abdominal endoscope;
- Figure 5 is a sectional view of the clamping and fixing means taken along line A-A Figure 3;
- Figure 6 shows the tool for picking up ovum, used in the first embodiment;
- Figure 7 is an enlarged view of the aspirator needle details in Figure 6;
- Figure 8 shows a sectional view of the rear end of the aspirator needle shown in Figure 6;
- . Figure 9 is a longitudinal section illustrating the structure of stop-cock for the aspirator needle;
- Figure 10 is a plan view of the stop-cock shown in Figure 9;
- Figure 11 illustrates a pressure welded member formed at the aspirator needle for the clamping and fixing means;
- Figure 12 shows a cross-section of the clamping and fixing means for the aspirator needle;
- Figure 13 schematically illustrates picking up an ovum by means of the first embodiment;
- Figure 14 illustrates a second embodiment of an aspirator needle for picking up ovum;
- Figure 15 is an enlarged view of the aspirator tool of Figure 14;
- Figure 16 is a section illustrating the structure of a stop-cock for the aspirator tool of Figure 14;
- Figure 17 is a side view of the stop-cock; and
- Figure 18 shows an aspirator needle inserted from the rear end of said aspirator tool.
- Figures 1 to 13 relate to a first exemplary embodiment of this invention. As can be seen from Figure 1, an abdominal endoscope 1 comprises a rigid,
elongate insertion sheath 2 extending from the front longitudinal end of acontrol body member 3 having a larger diameter or cross-section. From the rear end of thecontrol member 3, afirst channel 4 extends in axial alignment with theinsertion sheath 2, and asecond channel 5 branches obliquely back and down from thefirst channel 4 at the rear end of thecontrol body member 3, whilst an eyepiece member 6 extends obliquely back and upwards from the upper side of thecontrol body member 3. - The
insertion sheath 2 of said abdominal endoscope contains alight guide 7 comprising a bundle of very fine optical fibres for transmitting illuminating light, bent within thecontrol body member 3 to be fixed to a lightguide entry port 8. Illuminating light is transmitted from a light source (not shown) through a light cable (not shown) coupled to saidentry port 8, and on through thelight guide 7 to be emitted through the leading end face of the light guide to project onward to irradiate a forward zone (i.e. an organ) as shown in Figure 13. The end face of theinsertion sheath 2 also carries a sealedtube 9 receiving the observation optical system of the endoscope, which is inserted through the eccentrically arrangedtube 9 in the upper part of theouter housing 10 of thesheath 2. The front end of thisviewing tube 9 is sealed by a cover glass and receives an objective lens system, relay lens system or image guide for transmitting the image focused by said objective lens system to the eyepiece member 6, branched from thecontrol body member 3 through the observation optical system and eyepiece lens system (not shown) to an eyepiece 11 for the magnified image to be observed by theeye 12 of an operator. - A further hollow pipe extends through said
insertion sheath 2 eccentrically below, and adjacent theviewing tube 9, to define aforceps channel 13 in which can pass an operating tool or the like. As shown enlarged in Figure 3, thisforceps channel 13 is connected respectively with ahollow passage 14 within thefirst channel 4 and ahollow passage 15 in thesecond channel 5 each branched at the rear portion of thecontrol body member 3. - The
passage 14 within saidfirst channel 4 is connected with saidchannel 13 in alignment therewith and carries arubber cap 16 at its rear end, an intermediate stop-cock 18 being provided midway along thepassage 14, and by turning alever 19 in the direction of an arrow (Figure 1) can open the passage, or close it by turning thelever 19 back to the illustrated position. - The
rubber cap 16 has ahole 20 having a size smaller than the outer diameter of atool 21 for picking up ovum, so as to provide an airtight seal whentool 21 is inserted forwards through saidhole 20 and opened stop-cock 18, as indicated in Figure 3. - Said
second channel 5, branched from saidfirst channel 4 to extend obliquely downwards, is provided with amouthpiece 22 protruding down at a point slightly downstream from the branching position, andpassage 15 communicates withpassage 23 within thismouthpiece 22 so as to feed a veress gas from a veress cannula (not shown) via aconnector 24 coupled to saidmouthpiece 22. - Clamping and
fixing means 26 is provided within saidsecond channel 5 at a downstream position from the position provided with saidmouthpiece 22 so as to firmlygrip clamping forceps 25 when these are inserted throughpassage 15 withinchannel 5. A stop-cock 27 is provided downstream from said clamping means 26, and the insertion port positioned downstream from said stop-cock 27 at the end of thechannel 5 is covered by arubber cap 29 provided with a smallcentral hole 28. - The
stop cock 27 is designed to close or open thepassage 15 by pivotting aplug 32 that is provided with anopen passage 31 by manipulating acontrol lever 30, and is thus of a similar structure to the stop-cock 18 provided within thefirst channel 4, described above. - Said clamping and fixing means 26 have a structure as illustrated by Figures 4 and 5.
- Namely said means 26 comprise a
contact member 34 incorporated withinchannel 5 for defining a portion ofpassage 15, and acompression member 37 for clamping onforcepts 25 when inserted through the hollow portion of saidpressure contact member 34, by pressing on aflat member 35, formed for example by notching the outer periphery of saidcontact member 34 lengthwise to an appropriate length, and so reducing the width of asplit groove 36 formed by an axial notch so that said split groove is parallel to saidflat member 35 or the like.Compression member 37 is formed, for example, by a semi- hard rubber or plastic material, and is received through the tapered through hole in themain body 38 of the clamping and fixing means 26 as shown in Figure 5. The outer tapered periphery of saidcompression member 37 firmly contacts said tapered through hole and is notched to form aflat recess 39 to engage with theflat member 35 of saidcontact member 34, as shown in Figure 5. Under such a condition, thecontact member 34 has predetermined normal internal diameter to permit an insertedclamping forceps 25 to slide axially. Whenlever 40 provided at one end ofcompression member 37 is pivotted, theflat member 35 is turned from the position in which the recess or notchedportion 39 firmly contacts theflat member 35 ofcontact member 34, to the condition thatflat member 35 ofcompression member 34 is pressed against the tapered portion having no recess, at the corner of therecess 39 to reduce the width of thesplit groove 36 and so reduce the internal effective diameter to press and grip the shaft of the clamping forceps inserted through the inner portion over a wide contact area, to fix firmly the forceps so that they cannot slide axially. - The other end of the
compression member 37 remote from thelever 40 is machined stepwise to a small diameter, and covered by a threadedcap nut 41. Said cap nut is biased away from thecompression member 37 by aspring 43 between said nut and awasher member 42, so as to keep the contruction substantially air and watertight, a small amount of intervening grease being applied between the outer tapered ground periphery of thecompression member 37 and the inner tapered ground periphery of the through hole. Moreover, apin 44 is provided, protruding from the outer periphery of thecompression member 37 to act as a stopper controlling the pivotal angle of thelever 40. - The clamping
forceps 25 inserted in thesecond channel 5 provided with said clamping and fixing means 26 at an intermediate point, have a wire (not shown) inserted through the elongate flexible andhollow shaft 45 so that an alligator-mouth clamp 46 is provided at the tip of theshaft 45 as shown in Figure 4 is opened, for example, by manipulating the wire by a control (not shown) at the operating handle end, and closed to clip the desired objective organ by adjusting said wire. - A
handgrip member 47 for easily gripping thecontrol body member 3 is provided by flattening the portion to the rear of thelight guide mouthpiece 8 on the face remote from the eyepiece 11. - A
tool 21 for picking up ovum is inserted freely through thefirst channel 4 of the abdominal endoscope 1 as shown in Figure 6 to 8, and comprises a picking upneedle 51, andhollow aspirator needle 52 capable of being inserted through the inner hollow passage of said picking upneedle 51, providing means for aspirating, and for picking up ovum. - Said picking up
needle 51 comprises anelongate sheath tube 53 to be insertable from the inserting mouth at the exposed end offirst channel 4, through theforceps channel 13 in the abdominal endoscope, extending from anoperative member 54 formed by firmly securing a tubular or cylindrical member having a larger diameter at the trailing end of saidsheath tube 53 and provided with a knurled pattern for clamping and handling the sheath tube easily, and a finehollow tube 55 slidable in the axial, longitudinal direction within said sheath tube. - Said fine
hollow member 55, within saidsheath tube 53, is secured at the trailing end thereof, to the leading end inner periphery of a thick-walled and substantiallytubular handle member 56, and the finehollow member 55 biased axially forwards together with thehandle member 56 by means of aspring 57 fitted in a clearance defined between the outer periphery of the front half of thehandle member 56 and the surrounding inner periphery of thecylindrical operative member 54 as shown in Figure 7. In short, as shown in Figure 6 or Figure 7, the tip of the finehollow member 55 is protruded to an appropriate length from the tip of thetube 53, which is formed into sharp edge by cutting the hollow sheath member obliquely. The tip of said finehollow member 55 is provided with a hole, i.e.side hole 58, so as to irrigate a gas or physiological sodium chloride solution therethrough. Additionally aconvergent tip 59 having part-spherical or rounded shape is formed at the front of saidside hole 58. Afine hole 60 is pierced through the converged tip so that when theaspirator needle 52 is inserted along the central axis of the finehollow member 55 via thehole 66 it protrudes through thissmall hole 60 at the inserted end of the endoscope. Thespring 57 for biasing said finehollow member 55 to be protruded through thesmall hole 60 is controlled by abutting the leading end thereof with the leading end of the handle member, for example with anut 61 threaded onto thehandle member 56, and the trailing end of the spring abuts against the leading end of a cylindrical slidingmember 62 connected at the trailing end of the cylindrical member, comprisingoperative member 54 and telescoped around the outer periphery ofhandle member 56. Said slidingmember 62 is provided with an elongateaxial groove 63, for example, on the upper side of the inner periphery fitted through saidhandle member 56, for receiving aguide pin 64 at a position so that when the tip of the finehollow member 55 is displaced backwards by pressing, thehollow member 56 is contracted longitudinally and theguide pin 64 also displaced backwards along thegroove 63, and when theguide pin 64 abuts against the rear end of theelongate groove 63, thetip 59 of the finehollow member 55 is positioned within the obliquely cut tip of thesheath tube 53. It should be noted in Figure 6 or Figure 7 that thesheath tube 53 cannot be displaced from the position as shown in the solid line to the position as shown by a chain-dotted line in Figure 7, but when thehollow member 55 is retracted backwards, the tip of the finehollow member 55 is retracted within thesheath tube 53, as shown by the chain-dotted line in Figure 6. - Moreover, the fine
hollow member 55 is normally attached so that saidside hole 58 is positioned to protrude from the tip of thesheath tube 53. Such position may be precisely adjusted, for example, by the position of fixing but 61, or alternatively, for example, by protruding another pin forwards from thehandle member 56 to the position apart from the leading end of the slidingmember 62. - The
spring 57 for biasing said finehollow member 55 so as to protrude thetip 59 of the finehollow member 55 is designed so that the spring is contracted together with the elastic member comprisinghandle member 56 by a weak force for abutting thetip 59 of the finehollow member 55 against the ovarian follicle, and on pressing it further the sharp edge of thesheath tube 53 is protruded for piercing the edge into the follicular membrane. - The latter half portion adjacent to the portion attached with sliding
member 62 ofhandle member 56 has a thick, stepped wall and the trailing end of the handle member is internally machined so as to form amouthpiece 65 as shown in Figure 8. Thismouthpiece 65 is covered with arubber cap 67 provided with a smallcentral hole 66 in which to insert theaspirator needle 52. - There is provided a stop-
cock 69 in the thick-walled portion of thehandle member 56, slightly forward from saidmouthpiece 65, so that when theaspirator needle 52 is not inserted in thehollow passage 68, the openedpassage 68 throughmouthpiece 65 can be closed by pivotting alever 69A. - In addition, there are provided holding and fixing means 70 for securing the
aspirator needle 52, when inserted through saidhollow passage 68, and in thehandle member 56 at a point slightly forward of said stop-cock 69, and a further stop-cock 72 is provided, with a throughhole 71 connecting to thehollow passage 68 in thehandle member 56 to protrude downwards at a position forward of said holding and fixing means. Said stop-cock 72 has a structure as illustrated, for example, by Figure 7, 9 and 10. - Namely, the through hole or
passage 71 within the stop-cocks 72 connects amouthpiece 73 with thehollow passage 68 of thehandle member 56. Stop-cock 72 is provided with a through hole having a diameter larger than said throughhole 71, and the hole contains aplug 74. The through hole has a tapered passage therein, and a larger diameter at one end, and theplug 74 is ground down and attached so as to maintain a tightness between the ground surfaces. Theplug 74 is tapered at the trailing end and attached with alever 75 protruding rectangularly at the trailing end, so that theplug 74 is pivotted by actuating thelever 75 for connecting thehole 76 with the throughhole 71, as shown in Figures 9 and 10, or for blocking the throughhole 71 as shown in Figure 7. The end of theplug 74 protruding in the direction opposite to the end provided with thelever 75 is stepped to a smaller diameter and connected withnut 77 which defines a recess around the outer periphery of the stepped end of saidplug 74, for receiving aspring 79 within the recess between awasher member 78 and thenut 77, to urge the nut in the direction opposed to plug 74 by the action of saidspring 79 so that the plug is held firmly in contact with the ground portion of the stop-cock 72, to maintain gas and liquid seals. - A
pin 80 protrudes from theplug 74 and acts as a stopper for controlling the pivotting range of thelever 75, which is a similar structure to that of the stop-cock 69. - On the other hand, holding and fixing means 70 holds and fixes
aspirator needle 52, when inserted forwards through therubber cap 67, to grip said picking upneedle 51 and not allow it to slide axially, and has a structure as shown in Figures 7, 8, 11 and 12. - Namely, said means 70 comprise a
contact member 85 having aflat member 84 formed, for example, by notching the outer periphery of the cylindrical or tubular member defining aninsertion hole 83 capable of receiving thehollow member 82 of anaspirator needle 52 longitudinally, acompression member 87 for reducing the effective inner diameter of theinsertion hole 83 by reducing the width of asplit groove 86 formed longitudinally along saidcontact member 85 by pressing saidflat member 84, and amain body 88 of the holding and fixing means 70 comprising a housing for receiving saidcontact member 85 andcompression member 87. - Said
compression member 87 is formed into a frustrum of a cone ground to fit through the inner wall of a tapered through hole formed through themain body 88 of the holding and fixing means. Arecess 89 on the conical peripheral surface is held in firm contact with the inner wall surface of said through hole, for example, by notching. The inner bottom surface of saidrecess 89 is flattened so as to engage against saidflat member 84 of thecontact member 85, as shown in Figures 7 or 12. Under the fitted condition, the inner diameter of the throughhole 83 of thecontact member 85 is such that theaspirator needle 52 can be slidably inserted axially and means 70 can hold and fix theaspirator needle 52 by pivotting thelever 90 to press upon theflat member 84 of thecontact member 85, which has been closed by contact with the tapered corner portion ofrecess 89, thereby reducing the width of thesplit groove 85 of thecontact member 85 and reducing the effective inner diameter of the throughhole 83. Thehollow member 82 of theaspirator needle 52 is prevented from deformation or collapse by pressing and fixing theaspirator needle 52 via thecontact member 85 provided with itssplit groove 86, in lieu of direct compression and fixation, thereby increasing the area of contact with theaspirator needle 52. Such compression and fixation can be relieved easily by pivotting thelever 90. - That end of the
compression member 87 remote from the end attached to thelever 90 is stepped to a smaller diameter as shown in Figure 12, and threaded to carry acap nut 91 that is provided to hold the ground tapered portions of thecompression member 87 and the surrounding inner wall surface in close contact and maintain a gas tight, sealed hydraulic fit, thenut 91 being biased in the direction opposed tocompression member 87 by means of aspring 93 between thenut 91 and awasher member 92. A protruding pin on the outer periphery of thecompression member 87 acts as a stopper controlling the pivotting angle of thelever 90. - The
main body 88 of the holding and fixing means receives saidcontact member 85 and, as shown in Figure 7, the outer periphery of themain body 88 is provided with a recess around the trailing end for fitting an 0-ring 95 therearound, and for inserting firmly through the machined inner periphery of thehandle member 56 at the trailing end thereof to maintain a gas tight hydraulic seal. In addition, agroove 96 is formed around the outer periphery of saidcontact member 85 at the vicinity of the leading end, to facilitate gripping with the fingers when dis- sasembling acontact member 85 from acompression member 87. Moreover, the insertinghole 83 is machined around the leading portion fromflat member 84 ofcontact member 85 so as not to contact the inner periphery ofhole 83 excessively with the outer periphery of thehollow member 82 of theaspirator needle 52 and to minimize the friction of sliding thehollow member 82 when an inserted aspirator needle is not held pressed to be fixed in position. - On the other hand, the
aspirator needle 52 inserted through said picking upneedle 51 comprises the elongatehollow member 82 and ahandle member 97 having a larger diameter at the rear. Amouthpiece 98 at the trailing end of said handle member enables it to be connected with an aspirator such as syringe or the like by means of a tube or the like. - The operation of this first embodiment of an abdominal endoscope for picking up an ovum will now be described with reference to Figure 13.
- If an alveolar ovarian follicle has grown on an ovary surface, the abdominal wall can be provided with a guide hole by piercing it with a trocar. The
insertion sheath 2 of an abdominal endoscope 1 can be inserted through said guide hole and veress gas infused through themouthpiece 22 on thesecond channel 5, facilitating the insertion of abdominal endoscope 1 and the observation and subsequent operation for picking up the ovum. Thefallopian tube 99 connected to theuterus 100 and ovary 100a are observed by means of the optical system of the inserted abdominal endoscope 1. If the presence of an alveolarovarian follicle 100b on the ovary surface is confirmed, clampingforceps 25 are inserted through thesecond channel 5 of the abdominal endoscope 1, to pass throughpassage 15, and a picking upneedle 51 is inserted through thefirst channel 4 to pass throughpassage 14. - Under observation by the abdominal endoscope 1, supported by one hand of the operator, the vicinity of grown ovarian follicle 102 is clamped by means of the
alligator mouth grip 46 at the tip of the clampingforceps 25, by operating the handle of the clampingforceps 25 that protrude forwards throughforceps channel 13 of said abdominal endoscope 1 and locked by thepivotting lever 40 for said clamping and fixing means 26.Compression member 37 presses theflat member 35 of thecontact member 34 by pivotal operation of thelever 40 to hold and fix the clampingforceps 25 firmly and non-slidably longitudinally. Accordingly, the operator can then remove his hand from the secured clampingforceps 25 and act to protrude the picking upneedle 51 through the leading end of theforceps channel 13 of the first embodiment. - In such a case, the aspirating
needle 52 is provisionally inserted from the trailing end of said picking upneedle 51 to pass therethrough so that the tip of latter needle is retracted slightly into the tip of thesheath tube 53 and thehollow member 82 of theaspirator needle 52 is fixed by pivotting thelever 90 of the holding and fixing means 70. -
Compression member 87 is then pressed on theflat member 84 of thecontact member 85 by pivotting saidlever 90 to reduce the effective inner diameter of the insertinghole 83 of saidcontact member 85, and to press thehollow member 82 of theaspirator needle 52 to fix it firmly and non-slidably longitudinally. - Under such a condition, with said
aspirator needle 52 fixed, the tip of the picking upneedle 51 is abutted against alveolarovarian follicle 100b that is to be picked up, whilst under observation via the abdominal endoscope 1, and can be pressed gently forwards. The tip of the finehollow member 55 is then retracted by such pressing, to protrude the sharp edge of thesheath tube 53, thereby forming a small opening. When the opening has been enlarged to a size capable to accept the converged tip of the finehollow member 55, the piercing by the sharp edge of thesheath tube 53 is stopped, to relieve the pressure of thetip 59 of the finehollow member 55 against the membrane of ovarian follicle, so that thetip 59 of saidhollow member 55 is protruded automatically through the opening to be inserted into theovarian follicle 100b. In such a case, the vicinity ofovarian follicle 100b is clamped and fixed by thealligator mouthgrip 46 at the tip of the clampingforceps 25 so thatovarian follicle 100b is positively held immobile in position when the protruded tip of said picking upneedle 51 presses theovarian follicle 100b that is to be pierced, safely and correctly at the desired portion, to form an opening for picking up the ovum. In addition, thetip 59 of the finehollow member 55 inserted through said opening is rounded so as to be inserted without danger of injuring the ovum, even when thetip 59 is inserted to a substantial depth of theovarian follicle 100b. When thetip 59 of said finehollow member 55 is to be inserted, biological sodium chloride solution is infused through themouthpiece 73 formed within thehandle member 56 of the picking upneedle 51, to maintain theovarian follicle 100b under non- contracted normal condition or swollen condition, theaspirator needle 52 inserted through the picking upneedle 51 and fixed so that the tip of the latter needle is retracted to some extent from the tip of thesheath tube 53, relieved from fixation by the pivotal motion oflever 90 and displaced forwards. When the tip of aspiration needle is protruded through thesmall hole 60 of the finehollow member 55 to an appropriate depth into theovarian follicle 100b, the ovum is aspirated and received together with the saline water within thehollow member 82 by displacing backwards the piston of an aspirator of the syringe type connected via a tube with themouthpiece 98 formed at thehandle member 97 for theaspirator needle 52. The aspirator needle is then withdrawn from the picking up needle andlever 69A of the stop-cock 69 operated. - As mentioned hereinbefore, the ovum can be picked up into the aspirator tube in a simple manner.
- According to said first embodiment, holding and fixing means 70 are provided for the
aspirator needle 52 so that when the ovum is picked up by inserting the picking upneedle 51 through thechannel 13 of the abdominal endoscope 1, the picking upneedle 51 is inserted through theaspirator needle 52 and can be fixed at an appropriate retracted position from the tip of theaspirator needle 52. Hence, when operation other than aspiration by theaspirator needle 52 is carried out, said first embodiment assures operational safety, in that theaspirator needle 52 is prevented from any displacement to protrude the tip of the aspirator needle to a substantial depth in theovarian follicle 100b, to possibly injure the ovum or deeper tissue, and the ovum can be aspirated and picked up efficiently within a short period of time only by relieving the fixation and protruding the tip of theaspirator needle 52 slightly forwards. In addition, if there is any possibility of displacement of theaspirator needle 52 when only the aspirator is operated for aspirating and picking up operations, theaspirator needle 52 can be fixed in position at an appropriate depth in the ovarian follicle with ease. In addition, when aspirator needle is fixed, the operator can remove his hand from the fixedaspirator needle 52 and can perform other operations, so that a single operator or a small number of operators can pick up the ovum. - It should be noted that the first embodiment is designed to aspirate and pick up the ovum by inserting the
aspirator needle 52 through the picking upneedle 51, but means for aspirating and picking up the ovum are not restricted to such a structure, and can be designed so that the means incorporate noaspirator needle 52 and provide noside hole 58, but aspirate and pick up the ovum directly via thesmall hole 60. In such a case, it is preferred to infuse saline water or the like into theovarian follicle 100b, and aspirate and pick up the ovum together with the saline water. In such a modification, eliminatingaspirator needle 52, the trailing end of the finehollow member 55 is not fixed by ahandle member 56, but extended back to the portion for inserting theaspirator needle 52 and fix the needle by means of holding and fixing means 70. In such a case, the inner diameter of theinsertion hole 83 should be compatible with the outer diameter of thefine follow member 55, of course. - In the picking up
needle 51 constructed according to said first embodiment, the structure is not restricted to biasing the finehollow member 55 to protrude it forwards by the action of thespring 57, but may be designed so that the finehollow member 55 is protruded or retracted manually. Alternatively, thesheath tube 53 may be protruded or retracted from the finehollow member 55. - In addition, the obliquely cut tip of the
sheath tube 53 may be modified so that the furthermost portion of the tip is sharpened and the trailing portion of the tip is rounded, so as to pierce the furthermost portion and to form an opening by rotating the furthermost tip. In such a modification, the length of the furthermost sharpened portion of the tip is adjusted to about the thickness of an ovarian follicle, the sharpened edge cannot then pierce into the ovarian follicle so that the possibility for injuring the ovum can be eliminated substantially completely. Moreover, in such a case, the sharpened edge is limited to a length slightly smaller than the thickness of an ovarian follicle, to cut circularly the follicle to about the roundedportion 59 of finehollow member 55 or the like and to press the circular portion to provide an opening so as to be inserted into the follicle. - Still further, means for fixing the
aspirator needle 52 or the finehollow member 55 are not limited to those of said first embodiment, but include fixing thecontact member 85 by pressing, for example, by a thread. Still further, if theaspirator needle 52 or the like can be fixed in a manner not liable to collapse theaspirator needle 52 or the like, such means can be structured to be pressed directly. For example, if thecompression member 87 is made of soft material such as rubber or the like, theaspirator needle 52 or the like can be pressed and fixed directly. - Furthermore, when the
aspirator needle 52 is employed as means for aspirating and picking up the ovum, an aspirator such as syringe or the like may be incorporated without providing amouthpiece 98 at thehandle member 97. When theaspirator needle 52 is not employed, the handle side of the fine hollow member can be modified as mentioned above. - A second exemplary embodiment of this invention will now be described with reference to Figures 14 to 18.
- The abdominal endoscope to be used in this second embodiment is the same as that shown in Figure 1.
- A
tool 118 for picking up the ovum is insertable throughchannel 13 from the rear end of thechannel member 4 of said abdominal endoscope 1, and composed of a picking upneedle 121, as shown separately in Figure 14, or in Figure 15 on enlarged scale, and ahollow aspirator needle 122 is insertable through the hollow passage within said picking upneedle 121. - Said picking up
needle 121 is composed of anelongate sheath tube 123 inserted through theforceps channel 13 of the abdominal endoscope 1, with ahandle member 124 comprising a tubular or cylindrical member having a larger diameter connected with the rear end of saidsheath tube 123, and having the outer periphery thereof formed with a knurled pattern to facilitate grasping it easily, and the finehollow member 125 is attached slidably axially or longitudinally within saidsheath tube 123. - As shown in Figure 15, said fine
hollow member 125 within saidsheath tube 123 is secured fixedly to the inner periphery of a thick-walled and substantially tubularmain handle body 126 having the rear end made of a flexible elastic member at its leading end. Said fine hollow member is biased by the action of aspring 127 fitted around the clearance defined between the forward peripheral surface of themain handle body 126 and the inner periphery of the tubular member forminghandle member 124, together withmain handle body 126, so as to protrude axially forwards. Namely, as shown in Figures 14 or 15, the tip of the finehollow member 125 is cut obliquely, so as to protrude from the tip of thesheath tube 123 comprising a sharp edge of appropriate length. The tip side of said finehollow member 125 is provided with a hole at the side thereof, i.e.side hole 128, so as to infuse gas or physiological sodium chloride solution (referred to hereinafter as saline water). The portion forwards of theside hole 128 is formed into a spherically rounded convergedtip 129. There is provided ahole 130 at the furthermost portion of said converged tip, so that anaspirator needle 122 inserted through the central axis of thefine follow member 125 can protrude through saidhole 130. -
Spring 127 acts to bias said finehollow member 125 to be protruded therefrom and the leading end is controlled by abutting, for example, againstnut 131 threaded at the leading end of themain handle body 126 and the trailing end thereof is controlled by abutting against the leading end of an elastictubular sliding member 132 connected with the rear end of the tubular member comprising thehandle member 124 and fitted around the outer periphery of themain handle body 126 at about the central portion. Said slidingmember 132 has an axiallyelongate groove 133 on the inner periphery of themain handle member 126. Aguide pin 134 is received within saidelongate groove 133, and secured to themain handle member 126 so that when the tip of the finehollow member 125 is retracted backwards by pressing it, themain handle member 126 is retracted longitudinally and theguide pin 134 is also displaced backwards within theelongate groove 133 until theguide pin 134 abuts against the furthermost end of theelongate groove 133, when thetip portion 129 of the finehollow tube 125 is retracted to the inside of the obliquely cut tip of thesheath tube 123. Moreover, in Figures 14 or 15, thesheath tube 123 is not displaced from the position as shown by the solid line to that as shown by a chain-dotted line, but when the finehollow pipe 125 is retracted backwards, the finehollow pipe 125 is retracted to the position shown by the chain-dotted line in the inside of thesheath tube 123. - Furthermore, the fine
hollow member 125 is normally attached so that theside hole 128 protrudes from the tip of thesheath tube 123. In such a case, the position can be minutely adjusted, for example, by the position of the fixingnut 131. The position can also be adjusted by providing saidguide pin 134 or another pin to themain handle body 126 at a forward position from the leading end of the slidingmember 132. -
Spring 127 acts to bias said finehollow member 125 to press itstip 129 against the ovarian follicle and thetip 129 together with the elastic member comprising themain handle body 126 is then retracted due to the weak force being overpowered. The sharpened tip of thesheath tube 123 then protrudes in place of thetip portion 129 of finehollow member 125, so as said sharpened tip pierces the membrane of ovarian follicles. - The rear end of said
main handle body 126, which is in the vicinity of the portion attached by slidingmember 132, is stepped to a larger diameter and the rear end of the stepped thick-walled portion is machined to a small diameter to form amouthpiece 135, which is covered by arubber cap 137 provided with asmall hole 136 for the insertion of anaspirator needle 122, forwards through saidsmall hole 136, as shown in Figure 18. - There is provided a stop-
cock 140 at the thick-walled portion of themain handle body 126 at a position slightly forward of themouthpiece 135, so that thehollow passage 138 can be closed, and is opened to themouthpiece 135 when theaspirator needle 122 is to be inserted, the stop-cock being controlled by the pivotal operation of alever 139. - There is also provided a stop-
cock 142 provided with a throughhole 141 for connecting thehollow passage 138 of themain handle body 126 to aprotruded mouthpiece 143. Said stop-cock 142 has, for example, a structure as shown in Figures 14 to 17. - Namely, a hole or
passage 141 in the stop-cock 142 acts to connect themouthpiece 143 with thehollow passage 138 of themain handle body 126. The stop-cock 142 has a through hole having a larger diameter than that of said throughhole 141, normal to the direction of said throughhole 141, and atapered plug 144 is inserted therein. Said through hole is tapered to conform with the ground surface of theplug 144, said ground, tapered surface acting to maintain the tightness. The plug rear end of larger diameter is machined to a smaller diameter and provided with a protrudinglever 145 normal to the plug axis, so that theplug 144 is pivotted by pivotal operation of saidlever 145 between a position in which the throughhole 146 formed through saidplug 144 is connected to the throughhole 141, as shown in Figure 16 or blocked from said through hole as shown in Figure 15 or by the chain-dashed line in Figure 16. The opposite end of saidplug 144 is stepped to a smaller diameter and secured by anut 147 with a recess around its outer periphery. Aspring 149 is received within the space defined by said recess and awasher member 148, to press thenut 147 in the direction away from theplug 144 by the action of thespring 149, so as to hold theplug 144 closely in contact with the ground surface of the through hole to maintain a gas and liquid tight fit. - A
pin 150 protruding from theplug 144 acts as a stopper for controlling the pivotal angle of thelever 145. - Thus, the stop-
cocks - The
aspirator needle 122 which is insertable via therubber cap 137 of said picking upneedle 121 comprises the finehollow tube 151 inserted through thehollow passage 138 of the picking upneedle 121, and the clampingmember 152 having a larger diameter and connected with the rear end of said finehollow tube 151, and the rear end of said clampingmember 152 is formed as amouthpiece 153 capable of connecting an aspirator tool, such as syringe or the like. The tip of saidhollow tube member 151 is cut obliquely, such as is the needle tip of a syringe, and the sharpened edge is designed to protrude from thesmall hole 130 provided at the rounded tip after the sharpened tip of thesheath tube 123 has pierced into the membrane of ovarian follicle so that when the sharp edge of the finehollow tube 151 is pierced into the membrane of an ovarian follicle, it can pick up the ovum by aspiration without injuring the ovum. - The method of picking up the ovum by means of the abdominal endoscope according to said second embodiment will now be described with reference to Figure 13.
- If an alveolar ovarian follicle has grown on the surface of ovary, the abdominal wall of mother's body can be provided with a guide hole by piercing a trocar. The
insertion sheath 2 of an abdominal endoscope 1 may then be inserted through said guide hole. A veress gas is infused through the stop-cock mouthpiece 22 provided in the vicinity of the branch of thesecond channel 5 for facilitating the insertion of laparoscope 1 and observation and subsequent picking up operation. Theinsertion sheath 2 of the abdominal endoscope 1 is then inserted and the ovary 100a connected touterus 100 through afallopian tube 99 is observed via the optical observation system through the eyepiece 11 from the tip ofinsertion sheath 2, as shown in Figure 13. When the presence of alveolarovarian follicle 100b is confirmed on the surface of ovary 100a, the clampingforceps 25 is inserted forwards from the rear end of thesecond channel 5 of the abdominal endoscope 1 throughpassage 15 and the picking upneedle 51 is inserted forwards through thepassage 14 within saidchannel 4 from the rear end of thefirst channel 4. - The vicinity of the grown
ovarian follicle 87 is clamped by thealligator mouthgrip 46 at the tip of the clampingforceps 25 protruded forwards through thechannel hole 13 of said abdominal endoscope 1 by manipulating the control handle of theforceps 25 under the observation of the abdominal endoscope grasped by one hand, the clampingforceps 25 locked in the clamped condition. Thelever 40 of the holding and fixing means 26 is pivotted to permit thecompression member 37 to press theflat member 35 of thecontact member 34 provided with thesplit groove 36 to reduce the effective inner diameter and to hold and fix the clampingforceps 25 inserted throughchannel hole 13 so as not to be slidable axially. Accordingly, the operator can now remove his hand from the fixed clampingforceps 25 and proceed to effect the operation for protruding the picking upneedle 21 forwards from the leading end of thechannel hole 13 to bring the tip of theneedle 121 against theovarian follicle 100b to be operated, and press it forwards gently and carefully. Then the protruded tip of the finehollow member 125 is retracted by the pressure on the picking up needle, to cause the sharp edged tip of thesheath tube 123 to protrude and form a small opening. When said opening has been enlarged to a size capable to allow insertion of the convergent tip of the finehollow member 125, the piercing of sharp tip ofsheath tube 123 is stopped and tip 129 of finehollow member 125 is protruded automatically to be inserted intoovarian follicle 100b through said opening. Since the vicinity ofovarian follicle 100b is clamped and fixed by means ofalligator mouth 46 at the tip of clampingforceps 25,ovarian follicle 100b is prevented from the displacement when the protruded tip of said picking-upneedle 121 pressesovarian follicle 100b so that picking-upneedle 121 can be pierced safely and correctly through the desired portion to form an opening for picking up the ovum. Moreover, roundedtip 129 of finehollow member 125 has no possibility for injuring the ovum by inserting the tip intoovarian follicle 100b to a substantial depth, so that the ovum can be aspirated and picked up together with the saline water or veress gas fromovarian follicle 100b maintained under the normal condition or swollen by infusing the saline water or the like throughside hole 128 of finehollow tube 125 from the rounded tip ofaspirator needle 122 protruded throughsmall hole 130 of said finehollow member 125. By the way, the ovum is picked up by connecting an aspirator such as a syringe withcock mouthpiece 153 at the trailing handling end of clamping means 152 foraspirator needle 122 by means of a tube and aspirating by said aspirator. - According to said second embodiment, since said abdominal endoscope is attached branchedly with two
channels forceps 25 in addition to picking-upneedle 121, an opening for picking up the ovum can be formed safely and correctly under the condition that the vicinity of portion to be picked up by clampingforceps 25 and the ovum can be picked up conveniently by means ofaspirator needle 122 inserted throughsmall hole 130 of finehollow member 125. - Furthermore, since holding and fixing means 26 is provided within
channel 5 for inserting said clampingforceps 25, the forceps can be fixed firmly. Accordingly, the picking-up operation can be done only by one operator, if desired. Moreover, said holding and fixing means 26 don'tfixthe forceps locally by means of thread, etc., but pinch and fix the forceps over a wide area so that there is nofearto recess or deform such a hollow member. - Still further, in said second embodiment, flexible clamping
forceps 25 is inserted through bendedsecond channel 5 and rigid picking-upneedle 121 is inserted through straightfirst channel 4. However, such a mechanism is not limited so that a flexible picking-up needle may be inserted through the bended channel and the rigid clamping forceps through the straight channel which is provided, in turn, holding and fixing means. - The means according to this invention can be employed for picking up not only the human ovum, but also for animal ovum such that of a milch cow, beef cattle, race-horse, etc., which are desired to be bred maintaining a commercially high purity blood strain.
Claims (5)
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
AT85301118T ATE42675T1 (en) | 1984-02-20 | 1985-02-20 | ENDOSCOPIC INSTRUMENT FOR EGG COLLECTION. |
Applications Claiming Priority (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP3007584 | 1984-02-20 | ||
JP30075/84 | 1984-02-20 | ||
JP3502284 | 1984-02-24 | ||
JP35022/84 | 1984-02-24 |
Publications (2)
Publication Number | Publication Date |
---|---|
EP0153190A1 EP0153190A1 (en) | 1985-08-28 |
EP0153190B1 true EP0153190B1 (en) | 1989-05-03 |
Family
ID=26368361
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP85301118A Expired EP0153190B1 (en) | 1984-02-20 | 1985-02-20 | Endoscopic ovum picker instruments |
Country Status (3)
Country | Link |
---|---|
US (1) | US4700694A (en) |
EP (1) | EP0153190B1 (en) |
DE (1) | DE3569876D1 (en) |
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- 1985-02-20 DE DE8585301118T patent/DE3569876D1/en not_active Expired
- 1985-02-20 US US06/703,364 patent/US4700694A/en not_active Expired - Lifetime
- 1985-02-20 EP EP85301118A patent/EP0153190B1/en not_active Expired
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US8702727B1 (en) | 1999-02-01 | 2014-04-22 | Hologic, Inc. | Delivery catheter with implant ejection mechanism |
DE19935725A1 (en) * | 1999-07-29 | 2001-02-15 | Wolf Gmbh Richard | Medical instrument especially rectoscope has operating insert, coupling housing, shaft, seal on support, elastic support and axial passage. |
US6458077B1 (en) | 1999-07-29 | 2002-10-01 | Richard Wolf Gmbh | Medical instrument, in particular a rectoscope |
DE19935725C2 (en) * | 1999-07-29 | 2003-11-13 | Wolf Gmbh Richard | Medical instrument, especially a rectoscope |
US8231619B2 (en) | 2010-01-22 | 2012-07-31 | Cytyc Corporation | Sterilization device and method |
Also Published As
Publication number | Publication date |
---|---|
US4700694A (en) | 1987-10-20 |
EP0153190A1 (en) | 1985-08-28 |
DE3569876D1 (en) | 1989-06-08 |
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